Valve for stethoscopic monitoring

ABSTRACT

A pressure-activated, two-way valve means adapted for use in devices for monitoring blood pressure, pulse, and respiration during anesthesia. The valve communicates with a blood pressure acoustic pickup which is always open, but the pressure-activated feature automatically closes off communication with another acoustic pickup, e.g., a chestpiece, in response to inflation of the blood pressure cuff. The sound from the chestpiece is thereby temporarily shut off while the cuff is inflated.

Umted States Patent [151 3,693,61 1

Ploss [4 1 Sept. 26, 1972 [54] VALVE FOR STETHOSCOPIC 3,251,359 5/1966 lsmach ..128/145.8 MONITORING 3,138,152 6/1964 Wilson ..128/145.8 [72] wanton, William R- Ploss Gainesviupe Fla. 3,465,752 9/1969 Brychta et al. ..128/ 145.8 [73] Assignee: Minnesota Mining and Manufactur- FOREIGN PATENTS OR APPLICATlONS p y Paul, Minn- 627,864 8/1949 Great Britain...; ..137/87 22 Filed: Feb. 24 19 649,220 1/1951 Great Britain ..137/87 216,984 6/1924 Great Britain ..251/6l.l 1 p 13,524 1,272,861 8/1961 France ..25l/61.l

Related US. Application Data OTHER PUBLICATIONS 1 1 Continuation-impart 9f Anesthesia and Analgesia, Vol. 45, No. 5, pp. 472- March 19, 1968, Pat. No. 3,517,664. 475, 1966 Anesthesiology, Vol. 16, pp. 466- 467, 1955. [52] US. Cl. ..128/2.05 S, 137/87, 137/625.4,

251/611 Primary ExaminerKyle L. Howell [51] Int. Cl. ..A61b 5/02 Attorney l(inney, Alexander, Sell, Steldt & De La [58] Field o1Search.. ..128/2.05 S, 2.05 C, 2.05 A, H m

' /61.1 [57] ABSTRACT [56] References Cited A pressure-activated, two-way valve means adapted for use 1n devices for monitoring blood pressure, UNITED STATES PATENTS pulse, and respiration during anesthesia. The valve communicates with a blood pressure acoustic pickup 3,490,479 1/1970 M91161 a1. which is always Open but th.a pressurbactivated f 500,296 9/1926 0 M l 'f "128/205 ture automatically closes off communication with 2,902,108 9/1959 Br1sk1er ..181/24 another acoustic pickup a chestpiece, in 3,348,535 10/1967 Gregg ..128/2.05 response to inflation of the blood pressure ff The 2,746,471 5/1956 Cobb ..25 l/61.1 X Sound from the chestpiece is thereby temporarily Shut 1,017,857 2/1912 DQ111311 .,.251/61. 1 X Off while the cuffis inflated 3,083,943 4/1963 -Stewart, Jr. et al ..251/61.1 I 3,269,410 8/1966 Alvarado et a1. 1 37/6121 3 Claims, 4 Drawing Figures VALVE FOR STETHOSCOPIC MONITORING This application is a continuation-inpart of my copending U.S. Pat. application Ser. No. 714,226, filed Mar. 19, 1968 now U.S. Pat. No. 3,517,664, issued June 30, 1970.

This invention relates to a valve means. An important aspect of this invention is that the valve means is specially adapted for use in a constant monitoring stethoscopic system. A good monitoring system will not distract the anesthesiologists attention with visual (e.g., electronic) signals nor require the use of both hands. The need for a convenient, inexpensive acoustic constant monitoring system has become recognized. See, for example, Stethoscope Monitoring During Anesthesia, Joseph F. Patterson, M.D., Anethesia and Analgesia, Vol. 45, No. 5, pages 472-475 (1966). One form of a dual monitoring system was described in A Simple Constant Monitor System, R. E. Ploss, Anesthesiology 162466 (1955). The described system included a chestpiece and a blood pressure acoustics pickup, both connected to the same earpiece, in which a manually operated clamp was provided to cut off the sound from the chestpiece.

The present invention can be used in a constant monitoring system which permits continuous acoustical observation of vital function during surgical anesthesia. Thus the invention makes possible the immediate recognition ofbradycardia, arrhythmias and cardiac arrest. The invention further facilitates heart sound and blood pressure determinations while allowing the anesthesiologist comfortable, free movement, and maximum observation of the patient and the surgical procedure.

- piece and a blood pressure acoustic pickup through the nected by means of suitable tubing to earpiece 10 through the switchvalve 18 of this invention. Blood pressure cuff inflating means 20 which may be a manometer or hookup to a semi-automatic inflater, is connected to blood pressure cuff 16 by means of a conduit which also passes through valve 18. Valve 18 contains means which closes off the connection between chestpiece 12 and earpiece 10 in response to the application of pressure in cuff 16. The various tubing means can be provided with quick disconnect couplings, as indicated for example by numerals 22, 24, and 26. By means of these couplings, the various elements of the combination can be modified easily. For example, chestpiece 12 can be disconnected at coupling 24 and easily replaced by an esophageal pickup. Another modification of the system involves making a pressure measurement device (e.g., a manometer) an integral part of valve 18, as described hereinafter. Other similar substitutions will be apparent to those skilled in the art.

As shown in FIG. 2, the body of valve 18 is preferably comprised of a first (top) body portion 30 valve means of this invention. The valve is also interconnected with the tube leading from the inflater to the blood pressure cuff in such a manner that the passage from the chestpiece to the earpiece is automatically closed off when pressure is applied to the blood pressure cuff. The preferred valve of this invention is a diaphragm valve which is closed in response to pressure in the blood pressure cuff inflation system. In one embodiment of this invention, a pressure measuring means such as a sphygmomanometer is an integral part of the valve.

The invention will be further explained with reference to the accompanying drawings wherein:

F 16. l is a pictorial representation illustrating the use of the valve means of this invention in a constant monitoring stethoscopic system;

FIG. 2 is across-sectional view of a valve of this invention;

FIG. 3 isa top view ofthe bottom portion of a valve of this invention; and

FIG. 4 is aside elevation of FIG. 2 with parts broken away to show an embodiment of this invention wherein a pressure-measurement means, e.g., a sphygmomanometer is an integral part of the valve. 1

Referring more particularly to FIG. 1, it is seen that the constant monitoring system includes earpiece 10 which may be either a monaural or binaural earpiece, a chestpiece l2, and a blood pressure acoustic pickup 14 which is suitably positioned within blood pressure cuff l6. Chestpiece 12 and acoustic pickup 14 are both conthrough which inflating air for the blood pressure cuff passes, and a second (lower) body portion 32 through which the stethoscope is connected to the various acoustic pickup means. The top portion 30 is a housing for a first chamber, i.e., passageway 38, through which inflating gas passes from a source of air pressure to the blood pressure cuff. A first nozzle 34 is connected to the pressure source, and a second nozzle 36 is connected to the blood pressure cuff. These nozzles communicate with and are freely interconnected by a first chamber, i.e., passageway 38, which has a small, preferably circular, passage means 40 communicating with lower portion 32 and supplying pressure to a pressure-actuated means as is explained hereinafter.

Lower portion 32 of the valve is provided with a bypass means, in this case sound receiving chamber 48; with nozzle 42, which provides sound egress from chamber 48 and a means for connecting chamber 48 to the earpiece; with bypass nozzle 44, which provides sound ingress and means for connecting bypass chamber 48 to the blood pressure acoustic pickup means; and with nozzle 46, which provides sound ingress from another acoustic pickup such as a chestpiece, esophageal pickup, or the like as well as a means for connecting the valve to this additional pickup. Additional sound ingress channels could be provided, but

nozzles 44 and 46 will usually be sufficient for most purposes. Each of the nozzles is adapted to be encircled by a suitable elastomeric tubing which connects the various elements to the valve. As seen in FIGS. 2 and 3, nozzles 42 and 44 are always interconnected, i.e., there is free (unrestricted and unobstructed) passage therebetween via bypass chamber 48. Since the pulse sound is heard only when the blood pressure cuff is inflated, there is no sound interference at times when the blood pressure is not being measured. Nozzles 42 and 46 are interconnected by means of conduits 50 and 52 and through a contractible second chamber defined by an elastic diaphragm 56 and a concave valve seat 54.

The elastic diaphragm 56 serves as a pressure-actuated means for blocking sound and separates passage means 40 from the lower portion of the valve. When no pressure is being applied to the blood pressure cuff, the diaphragm 56 assumes the position shown by the dotted lines and thus the passageway between nozzles 42 and 46 is normally open so that sounds from the chestpiece are transmitted to the earpiece. However, when pressure is applied to the blood pressure cuff, diaphragm 56 is pressed downward as shown in FIG. 2 by means of air pressure applied through opening 40, thus seating in valve seat 54 and closing off conduits 50 and 52. An O-ring 58 or equivalent sealing means can be used for holding diaphragm 56 tightly in place. As shown in FIG. 2, it is preferred that O-ring 58 holds the outer periphery of diaphragm 56 against the lower part of valve portion 30 and is held in position by a curved portion 60 which surrounds the valve seat 54. Upper portion 30 and lower portion 32 of the valve can be held together by any conventional fastening means. For example, as shown in FIG. 3, the lower portion 32 can be provided with threaded tapped holes 62 and 64 so that the upper and lower portions can be held together by means of screws. If desired, a sealant can be applied between the two portions before assembly to provide an airtight seal.

While the preferred valve contemplates the use of diaphragm 56 for closing off passage between the chestpiece and earpiece upon application of pressure to the blood pressure cuff, it will be apparent to those skilled in the art that other pressure-responsive switch means can be substituted therefor. For example, an upwardly spring urged piston could be substituted for diaphragm 56. Other substitute valve mechanisms will be apparent to those skilled in the art.

In the embodiment of this invention shown in FIG. 4, the base of a pressure-measurement means 70, i.e., a manometer or the like, is an integral part of the valve 18. A passage 71 in top portion 30 of valve 18 communicates with a chamber 72 in the pressure measurement means 70. Chamber 72 and passage 71 permit the pressure of the inflating air for the blood pressure cuff which is passing through top portion 30, to be applied to a pressure-sensing element such as a diaphragm-inpot arrangement (not shown) in the pressure-measurement means 70. For the sake of compactness and convenience, the pressure-measurement device can be a sphygmomanometer which displays the pressure reading by deflection of a needle on a scale reading from, for example, 20-300 mm. It is also possible, but less compact and convenient, to use a manometer containing a column of liquid mercury for pressure-measurement means 70. Other suitable measuring devices will be apparent to those skilled in the art.

What is claimed is:

1. A valve comprising:

a first body portion integral with a second body portion, said first body portion defining a first chamber, said second body portion defining a valve seat having a periphery and a non-planar surface within said periphery, means communicating with said first chamber for connecting said first chamber to a source of pressure,

an elastic diaphragm means for responding to means communicating with said first chamber for communicating said first chamber with source of pressure and an inflatable cuff,

an elastic diaphragm means for responding to presilif-lafiil sti" c di'lillli iil'sifti l lfv tf ('3 sealing off said first body portion from said second bodyportion, and for defining, in combination with said non-planar surface defined by said valve seat, a contractible second chamber in said second body portion, said elastic diaphragm being interposed in a sealing relationship between said first body portion and said periphery of said valve seat and being sufficiently elastic to move toward and conform to the shape of said non-planar surface in response to an increase in pressure in said first chamber, thereby causing said contractible second chamber to contract,

means for defining an inlet and outlet conduit means integral with said valve seat, for providing comm unication between said inlet and outlet conduit means and said contractible second chamber, and for excluding communication between said inlet and outlet means except by way of said second contractible chamber,

means, integral with said second body portion, for

defining a bypass means for continuously unrestrictedly bypass bypassing said contractible second chamber and said inlet conduit means, for providing continuous unrestricted communication between said bypass means and said outlet conduit means, for excluding communication between said bypass means and said first chamber, and for excluding communication between said bypass means and said inlet means except by way of said outlet conduit means, and

a bypass nozzle means for providing direct communication into said bypass means without passing through said inlet or outlet conduit means.

2. A valve according to claim 1 wherein said first body portion communicates with a pressure-measuring device connected to said first body portion.

3. A valve according to claim 1 further comprising at least two nozzle means in addition to said bypass nozzle means, said nozzle means being integral with said second body portion and including:

- a first nozzle means for providing sound egress, said first nozzle means communicating with said bypass means and, when said diaphragm means is not seated on said valve seat, with said contractible second chamber, and

a second nozzle means for providing sound ingress to said inlet conduit means. I 

1. A valve comprising: a first body portion integral with a second body portion, said first body portion defining a first chamber, said second body portion defining a valve seat having a periphery and a nonplanar surface within said periphery, means communicating with said first chamber for connecting said first chamber to a source of pressure, an elastic diaphragm means for responding to means communicating with said first chamber for communicating said first chamber with source of pressure and an inflatable cuff, an elastic diaphragm means for responding to pressure in said first chamber, for seating upon said non-planar surface defined by said valve seat, for sealing off said first body portion from said second body portion, and for defining, in combination with said non-planar surface defined by said valve seat, a contractible second chamber in said second body portIon, said elastic diaphragm being interposed in a sealing relationship between said first body portion and said periphery of said valve seat and being sufficiently elastic to move toward and conform to the shape of said non-planar surface in response to an increase in pressure in said first chamber, thereby causing said contractible second chamber to contract, means for defining an inlet and outlet conduit means integral with said valve seat, for providing communication between said inlet and outlet conduit means and said contractible second chamber, and for excluding communication between said inlet and outlet means except by way of said second contractible chamber, means, integral with said second body portion, for defining a bypass means for continuously unrestrictedly bypass bypassing said contractible second chamber and said inlet conduit means, for providing continuous unrestricted communication between said bypass means and said outlet conduit means, for excluding communication between said bypass means and said first chamber, and for excluding communication between said bypass means and said inlet means except by way of said outlet conduit means, and a bypass nozzle means for providing direct communication into said bypass means without passing through said inlet or outlet conduit means.
 2. A valve according to claim 1 wherein said first body portion communicates with a pressure-measuring device connected to said first body portion.
 3. A valve according to claim 1 further comprising at least two nozzle means in addition to said bypass nozzle means, said nozzle means being integral with said second body portion and including: a first nozzle means for providing sound egress, said first nozzle means communicating with said bypass means and, when said diaphragm means is not seated on said valve seat, with said contractible second chamber, and a second nozzle means for providing sound ingress to said inlet conduit means. 